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8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN...

8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Ray A. Gapuz’s 3 Main Groups of Cancer Cells FUNCTIONAL CONCEPTS TYPE Carcinomas % DESCRIPTION 90% Epithelial cells; lungs, breasts, colon on Leukemias & lymphomas 8% Blood-forming cells; bone marrow lymphatic system CANCER Sarcomas 1% Connective tissues; bone, muscle, cartilage, fat FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 1 2 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® DNA refers to: RNA refers to: Deoxyribonucleic acid. It is the Ribonucleic acid. Acts as a messenger hereditary material in humans. carrying instructions from DNA. ChristineImiller. (29 December 2020). Simplified diagram of three types of RNA: Messenger RNA Transfer RNA Ribosomal RNA (Photograph]. Wikimedia Commons. Retrieved from https://commons.wikimedia.org/wiki/File:Types_of_RNA.png FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 3 4 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Phases of Cell Division Phases of Cell Division G0 Interphase Mitotic Resting Phase Cell Growth and Division Cell divides its copied DNA Cell is not dividing 3 Phases G1 phase: cells grow larger 2 phases S phase: DNA synthesis Mitosis: nuclear cell DNA -Duplication of centrosome condenses G2 phase: cells grows more Cytokinesis: two new cells are produced Morgan, D. (1 January 2007). The events of the eukaryotic cell cycle. Retrieved from https://commons.wikimedia.org/wiki/File:The_events_of_the_eukaryotic_cell_cycle.svg FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 5 6 1  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Cancer cells are: Benign cells Malignant cells 1. Large 2. Irregular size and shape 3. Prominent nucleoli Do not invade Able to invade 4. Scarce cytoplasm nearby tissues surrounding tissues 5. Either intensely colored or pale Can’t spread to Spreads through other organs the blood and Bordered lymphatics Borderless FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 7 8 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Terms used to describe abnormal cellular development FOCUS TERM DEFINITION DYSPLASIA - CHANGE IN SIZE,SHAPE AND APPEARANCE OF CELLS DEVELOPMENT OF HYPERPLASIA - INCREASE IN THE NUMBER OF CELLS - INCREASE IN THE SIZE OF MALIGNANT CELLS HYPERTROPHY CELLS copyright 2012 by R.A. Gapuz. copyright 2012 by R.A. Gapuz. 9 10 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN FOCUS CANCER SCREENING 11 12 2  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® To prevent cancer limit alcohol drinking. REMEMBER Men Women Cancer Screening Schedule. Age Group Men Women 2 drinks per day 1 drink per day 21-29 Colon Colon Breast Pap’s smear every 3 years * A drink is 12 oz 5 oz. of wine 30-39 Colon Colon of regular beer Breast 11/2 oz. of 80- Pap’s smear every 3 or 5 years proof distilled 40-49 Colon Colon Prostate Breast spirits Pap’s smear every 3 or 5 years copyright 2012 by R.A. Gapuz. copyright 2012 by R.A. Gapuz. 13 14 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® TEST INDICATION REMEMBER TSE Tumor of the testes Cancer Screening Schedule. PAP SMEAR/PELVIC Cervical cancer Age Group Men Women EXAM 50-64 Colon Breast (mammography every BSE BY THE CLIENT Breast mass Prostate year at age 50-54,every 2 BCE BY THE HEALTHCARE Lung years at age 55 onwards) Breast mass PROVIDER Pap test and HPV every 5 Non palpable breast years or pap test every 3 MAMMOGRAPHY mass years Colon DRE Prostate cancer Lung STOOL EXAM Colon cancer 65 and older Same Same SIGMOIDOSCOPY Colon cancer copyright 2012 by R.A. Gapuz. 15 16 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN NEW SBE PALPATION PATTERN 17 18 3  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® The best time to do BSE is The best time to do BSE is a two weeks after the start of week after your monthly period. your monthly period. 19 20 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® When there is average risk for breast When there is high risk for breast cancer due to cancer, perform breast examination. diagnosis of benign breast disease or breast cancer confined to milk ducts or lobule, women Age Self Trained should: Professional 20-34 monthly every 3 years Do SBE at age 20 35-39 monthly every 3 years CBE every 6 months starting at time of diagnosis Annual mammography starting at time of 40 and over monthly Annual +annual diagnosis Consider MRI mammogram 21 22 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® FOCUS Begin screening mammography: Women with Women with average risk high risk yearly age 50 -54 before age 40 DIAGNOSTIC every two years for the next 10 years MARKERS * American Cancer Society 23 24 4  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Type Diagnostic CANCER Marker D 1. Colon A. Beta Micro globulin (B2M) B. PSA B 2. Prostate C. Alpha-feto protein C 3. Liver D. Carcino Embryonic Antigen (CEA) A 4. Leukemia E. Estrogen/ E 5. Breast Progesterone receptor (ER/PR) 25 26 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® REMEMBER LET’S The most studied known or suspected risk factors for cancer include: Radiation Age Diet Immunosuppression, infectious agents Obesity Chronic inflammation, cancer causing substances Hormones Alcohol Tobacco Sunlight 27 28 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN RISK FACTOR TYPE OF CANCER PARITY Breast Cancer - NULLIPARA Ovarian Cancer Endometrial Cancer Ray A. Gapuz’s FUNCTIONAL CONCEPTS - MULTIPARA Cervical Cancer AGE Colorectal & Liver Cancer ALCOHOLISM RACE - JEWISH/WHITE - BLACK Breast & Colorectal Cancer on DIET - SMOKED - SPICY Smoked: Stomach Cancer Spicy: Esophageal Cancer Low Fiber: Colorectal Cancer CANCER RISK FACTORS - LOW FIBER/HIGH FAT SMOKING Smoking: Lung Cancer SEXUAL ACTIVITY Sexual Activity: Cervical Cancer copyright 2012 by R.A. Gapuz. 29 30 5  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® REMEMBER REMEMBER AGE ABOVE 55 IS THE NULLIPARITY INCREASES SINGLE MOST IMPORTANT THE RISK FOR BREAST RISK FACTOR TO CANCER CANCER 31 32 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® REMEMBER REMEMBER CANCER OF THE PROSTATE SMOKED, HIGH FAT PRESERVED AND THE CERVIX ARE FOODS INCREASES THE RISK FOR CANCER COMMON AMONG BLACKS copyright 2012 by R.A. Gapuz. 33 34 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® REMEMBER: REMEMBER: EARLY SEXUAL INTERCOURSE SMOKING INCREASES INCREASES THE RISK FOR ONE’S RISK TO CERVICAL CANCER! DEVELOPING CANCER! 35 36 6  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN FOCUS ASSESSMENT DATA SUSPECT LUMP SIGNIFICANT Breast cancer BREAST DISCHARGE PAINLESS HEMATURIA Bladder cancer CHANGING COUGH Lung cancer ASSESSMENT METRORRAGIA TUMOR in the TESTES Cervical cancer Testicular cancer CHANGE IN BOWEL HABITS DATA AND STOOL CHARACTERISTICS Colon cancer 37 38 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN FOCUS DATA NURSING DIAGNOSIS COMMON NURSING - FIRST TIME TO - KNOWLEDGE HAVE DEFICIT CHEMOTHERAPY DIAGNOSIS AMONG - INABILITY TO PERFORM A FUNCTION - POWERLESSNESS CANCER CLIENTS - TERMINAL STAGE - HOPELESSNESS 39 40 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® MASTERING THE MOST COMMON The gold standard diagnostic test for any DIAGNOSTIC TEST FOR types of cancer is biopsy of the tumor. CANCER 41 42 7  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Other tests will include: MASTERING 1. Physical Examination THE MOST COMMON 2. CXR 3. CT Scan TREATMENTS TO 4. Ultrasound 5. Visualization of the organ CANCER 43 44 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® FOCUS 1. Surgery BRACHYTHERAPY 2. Chemotherapy 3. Hormonal Therapy 4. Radiation Therapy 5. Targeted Therapy 6. Immune Therapy 45 46 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN BRACHYTHERAPY Functional Concept Functional Concept ® Brachytherapy involves internal radiation like use of cesium, radium, gold. Saran2008msc. (24 Jun 2012). Brachy therapy [Photograph]. Retrieved from Medicalpicture. (13 Apr 2021). Brachytherapy operation [Photograph]. Retrieved https://commons.wikimedia.org/wiki/File:Brachy_therapy.jpg from https://commons.wikimedia.org/wiki/File:Brachytherapy.jpg 47 48 8  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® BRACHYTHERAPY § It involves implant that is placed very close to or inside the tumor § It is placed so that it harms as few of the A client undergoing normal cells as possible. brachytherapy should § The radioactive material itself may be left not be delegated in the body for only a short time, or it may be left there permanently. § It allows the healthcare provider to give a higher dose of radiation to a smaller area than is possible with external radiation treatment. 49 50 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN BRACHYTHERAPY TYPES §Intracavitary radiation à During intracavitary radiation, the Functional Concept Functional Concept ® material is placed in a cavity (space) in the body, such as the uterus §Interstitial radiation the implants are placed in or near the cancer, but not in a body cavity. In unsealed source of Both methods involve using radioactive implants such as: radiation all body fluids are -Pellets contaminated and the greatest danger is within -Seeds -Ribbons -Wires -Needles the first 4 days! -Capsules -Balloons -Tubes 51 52 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® In sealed source of MASTERING radiation, urine and feces are not radioactive! THE MOST COMMON CANCERS 53 54 9  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Initiation of Tumor Formation (Germ cells undergoing genetic mutations) TEST ALERT! The 4 Most Fatal Cancer include: Local Invasion & Compression of blood vessels and lymphatic channels in testicle 1. Lungs (21%) Metastatic Spread & Secondary Tumor Formation 2. Colorectal (9%) 3. Pancreas (8%) 4. Breast (7%) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 55 56 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN CANCER OF THE Functional Concept Functional Concept ® Early menarche (< 12 years), late menopause, late age of first term pregnancy (>30 years), or nulliparity are risk factors for breast cancer. 57 58 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN BREAST CANCER Functional Concept ® Breast cancer can occur in both men and women. EDDAOUALLINE, H. (29 April 2017). Neglected breast cancer [Photograph]. Retrieved from https://commons.wikimedia.org/wiki/File:Neglected_breast_cancer_(Cancer_du_sein_n%C3%A9glig%C3%A9).jpg FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 59 60 10  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® In men, risk factors for breast cancer include: RISK FACTORS to BREAST CANCER includes: Liver disease Contraceptives Older age Age Obesity Nulliparity Klinefelter’s syndrome Cancer in a first degree relative Family history of breast cancer Early menarche and late menopause Exposure to estrogen Replacement therapy with estrogen-progesterone Testicle disease or surgery 61 62 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Common manifestations of cancer of the breast include: The most noticeable sign Newly inverted nipple of cancer of the breast is Inflammatory dimpling Peeling, scaling, crusting or flaking the presence of a breast Pigmentation and peeling of the skin lump or thickening. Lump or thickening Extra changes: size, shape, appearance, discharge FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 63 64 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept MAMMOGRAM BIOPSY Functional Concept Mammography is the primary and early breast cancer screening tool in asymptomatic individuals. Biopsy is considered the gold standard diagnostic test for confirming cancer. This test provides information about tumor characteristics (size, grade, hormone receptor status, treatment). 1. Fine-needle aspiration biopsy (FNAB) 2. Core needle biopsy (CNB) 3. Surgical (open) biopsy US National Institutes of Health – National Cancer Institute. (26 February 2006). Woman undergoing a mammogram of the right breast. Retrieved from https://commons.wikimedia.org/wiki/File:Mammogram.jpg 65 66 11  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN NEEDLE BIOPSY Functional Concept Functional Concept Functional Concept ® First-line treatment for breast cancer: 1. Surgery 2. Chemotherapy 3. Hormonal therapy – Tamoxifen Cleveland Clinic. (2021). Breast Biopsy. Retrieved from https://my.clevelandclinic.org/health/diagnostics/24204-breast-biopsy-overview 67 68 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN BREAST SURGERIES LET’S TRY § Radical Mastectomy: Surgical removal of the entire breast, pectoralis major and minor, lymph nodes § Modified radical mastectomy: removal of the breast and lymph nodes except the pectoralis major § Lumpectomy: removal of the tumor and the surrounding tissues § Simple mastectomy: removal of the breast but NOT the lymph nodes § Preventive mastectomy: indicated for clients at risk for breast cancer A SAMPLE QUESTION 69 70 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® LET’S TRY Special instructions for clients post-mastectomy include: 1. Start exercises the morning after surgery. 2. Take sponge baths until the drains or sutures are removed. 3. Phantom pain may be experienced. 4. Elevate the affected arm for 1 week after surgery. 5. Do not wear tight clothing, bands, or jewelry on the affected area. 6. Avoid tattoos on the affected area. A SAMPLE QUESTION 71 72 12  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® CANCER OF THE Race (African-American) is a risk factor for cancer of the prostate. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 73 74 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Prostate cancer manifestations include: P Pain or burning on urination R Recurrent urge to void at night BRCA 1 and BRCA 2 may O Overt straining on urination F Frequent urination increase the risk for U Urine/semen with blood (hematuria) prostate cancer. N New onset of erectile dysfunction D Discomfort when sitting FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 75 76 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® TRUS Transrectal ultrasound-guided prostate (TRUS) biopsy is the gold standard diagnostic test for prostate cancer. Liquor consumption, rather than wine or beer consumption, is a risk factor for cancer of the prostate. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 77 78 13  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® First-line treatment for prostate cancer: Prostate cancer and its treatment may cause 1. Surgery urinary incontinence. 2. Radiation therapy 3. Hormone therapy – androgen deprivation therapy FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 79 80 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Radical prostatectomy is done to remove the entire prostate gland and surrounding lymph nodes, in two ways: The advantages of robot-assisted prostatectomy include: reduced Robot assisted radical prostatectomy- 5-6 small pain , blood loss, trauma, shorter incisions are made on the lower abdomen hospitalization and quicker Open radical prostatectomy- incision is made in recovery period. the lower abdomen FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 81 82 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® After radical prostatectomy full TURP has been considered as recovery for erectile dysfunction may the most effective treatment take as long as 18 months. for an enlarged prostate. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 83 84 14  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Special instructions for clients post prostatectomy include: After simple prostatectomy, 1. Pain medications orgasm can be experienced 2. Start walking on the day of the surgery 3. Go home on the day after surgery and during sex but there will be comeback in 1-2 weeks for check up little or no semen. 4. Will have a catheter for 7-10 days. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 85 86 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Report the following: Special instructions for clients post-TURP: 1. Inability to urinate 2. Increased blood clots 1. Stay in the hospital for 1-2 days 3. Urine that is not becoming clear after 24 hours 2. Urinary catheter will be in place for 1-2 days 4. Fever above 100.4 degrees F (38C) 3. Avoid heavy listing for 4-6 weeks 4. Avoid sex for 4-6 weeks 5. Avoid driving until the catheter is removed and pain medications have been stopped FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 87 88 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN CONTINUOUS BLADDER Functional Concept ® IRRIGATION REMEMBER: CBI after TURP prevents CLOT FORMATION in the BLADDER 89 90 15  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® CANCER OF THE REMEMBER: MONITORING THE WEIGHT OF A CLIENT WITH CBI IS A NURSING PRIORITY! copyright 2012 by R.A. Gapuz. 91 92 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN LUNG CANCER REMEMBER Smoking is the most important preventable cause of cancer in the world. Emmanuelm. (11 February 2008). Lung cancer [Photograph]. Retrieved from https://commons.wikimedia.org/wiki/File:Lung_cancer.jpg copyright 2012 by R.A. Gapuz. 93 94 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® REMEMBER Risk factors to lung cancer include the following: Smoking accounts for 87% of lung cancer MODIFIABLE NON-MODIFIABLE UNCERTAIN deaths in men and 70% in women. Lung cancer (You can change) (You can not change) (Needs validation) is the leading cause of cancer death in both men Tobacco smoke (leading) Previous radiation therapy Smoking marijuana and women, and is one of the hardest cancers Second hand smoke Air pollution (slightly increase E cigarettes to treat. Exposure to radon (leading the risk) Talc and talcum powder in non-smokers) Personal or Family history Exposure to asbestos Exposure to uranium, (genetics) Lung cancer can often be prevented. Some arsenic,beryllium,cadmium,si religious groups that promote non-smoking as lica, vinyl chloride, nickel compounds,chromium part of their religion, such as Mormons and compounds, coal products, mustard gas,chloromethyl Seventh-day Adventists, have much lower rates ethers,diesel exhaust of lung cancer and other smoking-related Betacarotene supplements Arsenic in drinking water cancers. copyright 2012 by R.A. Gapuz. 95 96 16  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Common manifestations of cancer of the lung: The early symptoms of cancer Cough that changes Overly painful chest/back when coughing, of the lung are slight cough laughing or deep breathing and shortness of breath. Unexplained weight loss Gradual loss of appetite Hoarseness or wheezing FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 97 98 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® First-line treatment for lung cancer: The combination of imaging 1. Surgery studies (CXR, CT scan) and 2. Radiation therapy tissue biopsy are used for 3. Chemotherapy 4. Targeted therapy & immune therapy diagnosing lung cancer. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 99 100 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN LOBECTOMY CANCER OF THE Cancer Research UK. (30 July 2014). Diagram showing the removal of one lobe of the lung (lobectomy) CRUK 366 [Photograph]. Retrieved from https://commons.wikimedia.org/wiki/File:Dia gram_showing_the_removal_of_one_lobe_o f_the_lung_(lobectomy)_CRUK_366.svg Wojciech Filipiak. (15 March 2013). Lobectomy – surgery of removal of lung tumor [Photograph]. Retrieved from https://commons.wikimedia.org/wiki/File:Lobectomy_-_surgery_of_romoval_of_lung_tomor.JPG 101 102 17  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® The first-line treatment for colon cancer: Colonoscopy with biopsy is the gold standard procedure 1. Surgery for detection, diagnosis, and 2. Chemotherapy 3. Targeted therapy prevention of colon cancer. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 103 104 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Common manifestations of cancer of the colon include: African–American above 50 Rectal bleeding years of age have higher Abdominal cramps Feeling of bowel fullness (tenesmus) risk for cancer. Weakness or fatigue Unexplained weight loss FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 105 106 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN FUNCTIONALConcept Functional CONCEPT® FUNCTIONALConcept Functional CONCEPT® Lynch Syndrome Non-modifiable risk factors to colon cancer include: q Old name –HNPCC- hereditary advancing age (50 onwards), non-polyposis colorectal personal and family history of cancer polyps or cancer and IBD q Also causes- breast and (ulcerative colitis, Crohn’s disease), inherited syndromes. prostate cancer 107 108 18  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN FUNCTIONALConcept Functional CONCEPT® FUNCTIONALConcept Functional CONCEPT® Modifiable risk factors to colon Hereditary factors causes the cancer include: obesity, sedentary HIGHEST RISK for colon cancer lifestyle, diet high in red meat and while all other factors other than processed meat, smoking, alcohol- hereditary, causes an INCREASED drinking (not more than 2 RISK for colon cancer drinks/day for men and not more than 1 drink /day for women) 109 110 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN BOWEL DIVERSION SURGERY Colostomy Colostomy Ileostomy POINTERS Opening: colon to outside Opening: ileum to outside Discharge: depends on location Discharge: liquid 111 112 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® Functional Concept Functional Concept ® A bowel diversion may be done as treatment for: Inflammatory bowel disease Preparation for colostomy Injury to the bowels entails taking a laxative 1 Birth defects Bowel obstruction to 2 days before surgery. Cancer of the colon, rectum or anus Diverticulitis Familial adenomatous polyposis FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 113 114 19  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® Functional Concept Functional Concept ® Before surgery for The location of the colostomy colostomy, antibiotics or ileostomy affects the are given to help consistency of the stool. prevent infection. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 115 116 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® Functional Concept Functional Concept ® After colostomy, the following may occur: Bleeding A post colostomy client can Bowel obstruction engage in swimming, Blood clots Infection running or weight-lifting. Pain Prolapse of the intestines FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 117 118 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® Functional Concept Functional Concept ® In transverse colostomy, Empty your colostomy bag the pouch is changed no when it is 1/3 full. more than once a day. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 119 120 20  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept Functional Concept ® TRENDING !!! Phantom rectum a Post-Colostomy Activity feeling of a need move the bowels even when Allowed: Swimming Not allowed: Contact sports the rectum is no longer connected to the bowel. copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 121 122 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN BLADDER CANCER CANCER OF THE Nasimudeen, R. (24 March 2017). Papillary urothelial carcinoma of bladder [Photograph]. Retrieved from Scientific Animations. (29 August 2019). Bladder Cancer [Photograph]. Retrieved from https://commons.wikimedia.org/wiki/File:Papillary_urothelial_carcinoma_of_bladder.jpg https://commons.wikimedia.org/wiki/File:Bladder_Cancer.jpg 123 124 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® The first-line treatment for bladder cancer: Cystoscopy with biopsy is the gold standard test for 1. Surgery 2. Intravesical therapy or immunotherapy detection, diagnosis, and 3. Chemotherapy staging of bladder cancer. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 125 126 21  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Cigarette Alcoholism, alone does not smoking is the directly increase the risk for bladder cancer, alcoholism and most common smoking do. risk factor to bladder cancer. International Journal of Cancer FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 127 128 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Common manifestations of The most noticeable sign cancer of the bladder include: of cancer of the bladder Back pain is hematuria. Frequent urination Painful urination FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 129 130 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® Diagnosis of bladder cancer: Diagnosis of bladder cancer metastases: Cystoscopy CT scan Biopsy MRI Urine cytology PET CT scan Bone scan CXR FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 131 132 22  8/8/24 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® CANCER OF THE Surgical interventions for cancer of the bladder include: Transurethral resection of the bladder tumor Cystectomy Radical cystectomy Ileal conduit Continent urinary reservoir FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 133 134 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN UTERINE CANCER ENDOMETRIAL BIOPSY Прокопюк Владимир Юрьевич. (11 October 2016). Cancer uteri [Photograph]. Retrieved from Mount Sinai. (n.d.). Endometrial biopsy. Retrieved from https://www.mountsinai.org/health-library/tests/endometrial- https://commons.wikimedia.org/wiki/File:Cancer_uteri.jpg biopsy 135 136 The Ray A. Gapuz Test Prep System for the NCLEX RN The Ray A. Gapuz Test Prep System for the NCLEX RN Functional Concept ® Functional Concept ® The first-line treatment for uterine cancer: Post menopausal women 1. Surgery consuming 2 or more alcoholic 2. Radiation therapy drinks a day may double their 3. Hormone therapy – progestin therapy risk of endometrial cancer. Risk is higher in lean women. FUNCTIONAL CONCEPT ® IS A REGISTERED TR